经胸壁超声心动图联合血浆BNP检测对脑卒中医院感染患者心功能评估效果研究

Effect of transthoracic echocardiography combined with plasma BNP on evaluation of cardiac function of stroke patients with nosocomial infections

目的探究经胸壁超声心动图联合血浆B型尿钠肽原(BNP)检测对脑卒中医院感染患者心功能评估效果。方法选取2014年8月-2016年8月医院收治的80例脑卒中医院感染患者作为研究对象,根据是否有心功能不全分为对照组和研究组,各40例;对患者心功能分级与血浆BNP水平及经胸壁超声心动图进行相关性分析,对比两组患者经胸壁超声心动图检查及血浆BNP水平,及心功能分级的灵敏度和特异度。结果研究组患者血浆BNP水平及左室舒张末内径(LVIDD)值均高于对照组,左室射血分数(LVEF)值低于对照组(P<0.05);不同心功能Killip分级患者的血浆BNP水平、LVIDD值和LVEF值比较差异有统计学意义(Z=5.302,4.652,9.038;P=0.016,0.024,0.001);脑卒中医院感染患者心功能Killip分级与血浆BNP水平呈正相关(r=0.84,P=0.040),与LVEF值呈负相关(r=-0.87,P=0.039);经胸壁超声心动图检查联合血浆BNP检测,对脑卒中医院感染患者合并心功能不全有较高的灵敏度及特异度。结论经胸壁超声心动图联合血浆BNP检测不仅可评估脑卒中医院感染患者心功能水平,同时具有较高灵敏度及特异度,对指导临床治疗具有重要意义。

OBJECTIVE To explore the effect of transthoracic echocardiography combined with plasma B-type natriuretic peptide（BNP）on evaluation of cardiac function of stroke patients with nosocomial infections.METHODS A total of 80 stroke patients with nosocomial infections who were treated in the hospital from Aug 2014 to Aug 2016 were recruited as the study objects and divided into the control group and the study group according to status of cardiac insufficiency,with 40 cases in each group.The correlation between cardiac function grading,plasma BNP level and transthoracic echocardiography was analyzed,and the sensitivity and specificity of the transthoracic echocardiography combined with plasma BNP in evaluation of the cardiac function level were observed.RESULTS The plasma BNP level and left ventricular internal diastolic diameter（LVIDD）of the study group were significantly higher than those of the control group,while the left ventricular ejection fraction（LVEF）of the study group were significantly lower than that of the control group（P〈0.05）.There were significant differences in the plasma BNP level,LVIDD and LVEF among the patients with different Killip grades of cardiac function（Z=5.302,4.652,9.038;P=0.016,0.024,0.001）.The Killip grade of cardiac function of the stroke patients with nosocomial infection was positively correlated with the plasma BNP level（r=0.84,P=0.040）and was negatively correlated with the LVEF（r=-0.87,P=0.039）.The sensitivity and specificity of the transthoracic echocardiography combined with plasma BNP were high in evaluation of the stroke and nosocomial infection patients complicated with cardiac insufficiency.CONCLUSION The sensitivity and specificity of the transthoracic echocardiography combined with plasma BNP are high in evaluation of the cardiac function of the stroke patients with nosocomial infection,and it has great significance for clinical treatment.